You’re smarter than your audience. That’s the problem.

I once saw a brilliant doctor explain febrile convulsions to a parent.

He started with:

“It’s about hypothalamic thermoregulation.”

Accurate? Yes.
Useful? Not even close.

The parent nodded politely.
But nothing landed.

💡 ONE IDEA WELL

The more you know, the harder it is to explain.

This is The Curse of Knowledge—a bias where we forget what it’s like not to know something.

We assume shared language. Shared logic. Shared leaps.

But when we present from that place, we leave people behind.

We skip context.
We use acronyms without thinking.
We go straight to the clever bit—before anyone else has caught up.

And the kicker?

We believe we’re being clear.

In my writing workshop, I use this example:

What does ASD mean?

To a paediatrician: Autism Spectrum Disorder.
To a cardiologist: Atrial Septal Defect.

Same letters. Entirely different diagnoses.

And PE?

Pre-eclampsia to an obstetrician
Pulmonary embolism to most physicians
Physical Education to a layperson

We think we’re speaking plainly.
We’re just speaking fluently -in our own dialect.

The Curse of Knowledge hides in acronyms, assumptions, and slides that begin halfway through a thought process we never say out loud.

It’s not about intelligence.
It’s about proximity.
We’re too close to the content to see what others can’t.

🧰 LESS MESS, MORE MESSAGE

Here’s how to break the curse.

🧠 1. Speak to the least informed person in the room

Not the slowest. Just the one without your shorthand.
Build for them, and everyone benefits.

🔁 2. Use the “10-year-old” test

If you can’t explain it simply, you probably haven’t shaped it fully.
Clarity isn’t a sign of dumbing down - it’s a sign of knowing what matters.

🧭 3. Set the scene before delivering detail

Instead of:

“The CT showed a PE.”

Try:

“The CT showed a PE—saddle embolus, obstructing both main pulmonary arteries, and the child was peri-arrest when we got them to CT.”

Same diagnosis.
Very different weight.

Even among clinicians, terms like “PE” or “sepsis” or “floppy” can flatten urgency.
Framing restores meaning.

📏 4. Count your acronyms

If your slides look like a Scrabble rack - ECMO, DKA, SIADH, ADHD - it’s a red flag.

Spell it out. Especially the first time.

Even if it feels obvious.

(Especially when it feels obvious.)

📸 A BEFORE/AFTER SHIFT

Before:

“The child was described as irritable.”

After:

“The child was described as irritable -crying inconsolably, arching their back, refusing feeds, and unsettled even when held.”

To most people, “irritable” just means cranky or overtired.
To a paediatrician, it might mean meningitis or encephalitis until proven otherwise.

Same word.
Very different implications.

Clarity isn’t about sounding clinical.
It’s about making sure everyone’s hearing the same thing.

🧭 ASK YOURSELF THIS

If I were hearing this for the first time, what part would trip me up?

That’s your real starting point.

Because clarity doesn’t begin when you’re ready to explain.
It begins when they’re ready to understand.

Speak soon,

Andy

PS What do you think GCS stands for?

Glasgow Coma Scale to most of us.
Graduated Compression Stockings - according to the orthopaedic ward round I once joined.
And to your non-medical friend? Probably just… 🤷‍♂️.

Same acronym. Different realities.
That’s the Curse of Knowledge in three letters.

TEACHING ISN’T A SCRIPT. NEITHER IS THIS.